According to many, “successful aging” means aging independently, without anyone’s help. However, most folks over 70 require some form of assistance. In fact, it is rare for people to maintain all aspects of their lives without any extra care from professionals or loved ones as they age. But what does that mean for you, the caregiver for your aging parents?
Suddenly you’re the more responsible one, the more level-headed one, or at the very least, the more physically capable one. Tension and conflict can arise as the relationship dynamic with your aging parents shifts, and your patience is bound to be tested. To maintain your wellbeing, you’ll need solutions tailored to this situation.
How do I know if my parents need help?
You might notice your parents aren’t quite the same as they used to be, but wonder whether it’s worth taking seriously. As the body slows down, there are various red flags indicating the need for extra assistance.
Certain conditions and symptoms require extra care
You should frequently check in with your aging parents or arrange for a caretaker to do so if your parents have any of the following:
- Dementia, Alzheimer’s disease, or a related memory loss condition
- Advanced chronic illness such as pulmonary disease or heart failure
- Disability from a fall, stroke, or related emergency
- Difficulty recovering from hospitalization
- Loss of strength, cognitive decline, or overall frailty
- Schizophrenia, bipolar, or moderate to severe anxiety or depression
Activities of Daily Living (ADLs)
One easy way to determine whether an aging parent needs extra help is to take note of whether they can complete activities of daily living (ADLs) on their own. These activities include moving around, feeding oneself, bathing or showering, getting dressed, using the restroom, and maintaining personal hygiene by grooming. Even without any existing medical diagnoses, an aging parent may struggle with these tasks–that struggle, alone, indicates the need for more serious help.
The term “instrumental activity of daily living” (IADLs) is used a little differently. IADLs are not always required for everyday life, but ability to complete them can indicate whether an aging parent should continue living independently. IADLS include shopping for groceries and other necessities, cleaning and maintaining the home, preparing meals, paying bills, taking prescribed medications, running errands, and using the telephone. If your aging parents have difficulty with any of the above activities, you should seek extra support for them.
Associate Research Scientist Dr. Mary Janevic from the U-M School of Public Health notes that rather than needing someone to take care of them, many older adults simply need support when taking care of their health in a way that gives them the most independence. Dr. Janevic advises older adults with chronic conditions and their family members to keep an eye out for classes that teach them what they need to do to stay healthy. These classes are usually offered by community centers and senior centers.
Other signs to look out for
There are some signs that your aging parents need help that can’t be determined over a phone call and can only be seen through in-person visits. Holidays are the best time to assess your aging parents’ conditions, but if you live far from them, you may ask a neighbor to check on them in between visits. The following are telltale signs they need help:
- Bruises, which can indicate disorientation or falls
- Confusion, depression, or other personality changes
- Clutter or disorder, such as dirty dishes in the sink, scattered junk mail, spoiled food in the fridge, messy laundry, or an untended garden
- Charred pots and pans, or burn marks on the stove or countertop
Reasons aging parents resist help
When you call your mom and she tells you that everything is fine, she is not trying to deceive you; she probably just doesn’t want you to worry. According to a study done by the American Geriatrics Society, the top three reasons that aging parents refuse help are that they 1) fear losing independence, 2) don’t want to be a burden, and 3) don’t want to be taken advantage of or lose control over their lives. There’s a certain pride associated with “aging in place,” as it’s something many people think they “should” do.
However, this desire to maintain autonomy can sometimes result in aging parents intentionally withholding information about their condition from their adult children. Aging parents might even do things that are unsafe, such as shoveling snow out of the driveway despite having a bad back, as a way to prove to themselves that they are still capable. Unfortunately, it sometimes takes an accident and a hospital visit to realize something is wrong.
Remember when you were a teenager and you thought your parents were overbearing? Aging parents often appreciate the concern of their adult children, but are annoyed by the constant check-ins. They may feel viewed as incompetent. They want to feel cared about, but not cared for.
How can I support my aging parents emotionally?
When aging parents resist your help, the fight for control can risk their trust. Trust and understanding are what’s most needed in this situation. Above all, aging parents need to trust that you’ll listen to their concerns, prioritize their values, and stay by their side no matter what happens.
Research Scientist in the Center for Clinical Management Research at the VA Ann Arbor Healthcare System Dr. Jeff Kullgren notes that it’s common for adult children and their older parents to have different ideas about how to approach the challenges of aging. Because of this, you should periodically check in with your parents about how you can help them, knowing that their ideas may change over time. The goal is to help them figure out how they can “stay as independent as possible, while still ensuring that their health needs are met.”
It will help if you act as their partner, rather than their caretaker. Give them options whenever possible, and respect how and where they wish to age. If they struggle with ADLs, for example, and refuse your help, offer to hire an in-home aide. Show them that it’s you and them versus the challenge, not you versus them.
3. Avoid making promises
In an interview with Supportiv, Alexandra Drane, Co-Founder and CEO of ARCHANGELS, a movement and platform celebrating and uplifting caregivers, shares: “A good friend who has spent many years working with state resources for aging taught me a key piece of advice. She often recommends that when you’re caring for someone you love, give yourself the gift of not promising anything. Specifically, do not promise that you will never put someone in a nursing home. Do not promise that the person you love is never going to have to go into assisted living.”
Why shouldn’t caregivers make promises? Why shouldn’t they promise not to put their parents into assisted living, for instance? Drane explains: “It might be that you really, really want to be able to make that true. But given the realities of how care unfolds, it could be that it’s just not safe for the person you love to be at home. If you had promised them, ‘I will never put you in a nursing home,’ and then you legit have to, the person you promised that to will feel violated.”
So, how can caregivers respond when asked to make that promise? Speaking from personal experience, Drane shares a diplomatic idea: “What I say in my situation all the time is: ‘My goal is to keep you home. And as long as I can keep you home safely, and you’re comfortable, we’re doing that.'”
How can I get my siblings to help?
There are three main excuses that siblings use when they don’t want to help you care for your aging parents. They might either say they 1) don’t have the time, 2) don’t have the money, or 3) “can’t bear to see them like that,” particularly if the aging parent is sick or has a progressive disorder like dementia.
As you might feel old sibling rivalries stirring, it’s important to remember that no family is perfect. In fact, 40% of family elderly caregivers have intense family clashes, and 65% think that health care needs seem to be unequally shared among siblings.
While you can’t force your sibling to take initiative or spend quality time with your parent(s), you can suggest small, concrete ways in which they can help.
If your sibling lives far and doesn’t have time to drive back and forth to bring groceries, maybe they can contribute financially, either by chipping in to hire a driver or in-home aide, or to compensate the person shopping for them.
If they can’t afford that, maybe they can help with bookkeeping tasks, such as researching potential senior living options or securing financial aid. Maybe they can contribute to smaller purchases or even just commit to biweekly phone calls.
While it might be nice for your siblings to offer to contribute, you may have to be direct with your requests for help. Something like, “Mom needs a new cane from CVS. Can you drop one off by tomorrow morning?” can go further than you expected. Suggest alternatives that align with your sibling’s budget and schedule.
How can I avoid burning out?
With the added stress of caring for an aging parent on top of managing one’s own life and family, many adult children face burnout as they adjust to their new role. Caregivers are prone to insomnia, guilt, depression, anxiety, and career pressure. If you’re not careful, caregiving may become a source of chronic stress.
To avoid burnout, you should find ways to regularly destress. Maybe you can join a local community group, spend time with friends, or hit the gym after work. You might also find relief by asking others for help, setting boundaries, and allotting some time each day to tend to your own health and other needs, such as preparing a healthy meal.
President and CEO of the National Alliance for Caregiving C. Grace Whiting J.D. says that taking time for yourself can keep you from feeling lonely as a caregiver. “A lot of caregivers feel like their identity has been taken away from them because they’re spending all of their time caring for someone.”
How to stop feeling isolated? Seek out “other social interactions you can have which reinforce other parts of your identity, which allow you to come back to the person you’re caring for more refreshed.” You may choose to spend a night out with your partner, visit the park with your kids, or even just catch up with your knitting circle.
Caregiving is often thankless work, and you might think that no one else understands the burden you feel. Take heart in the knowledge that there are so many adult children with aging parents just like you. And remember that by taking time to help out your aging parents, you are helping them live the last few years of their life with ease and peace.
Resources for caregivers:
- Dr. Magda Podcast
- How To Care For Aging Parents
- Parenting Our Parents Blog
- Books for Caregivers
- David Solie Blog